Efrat Neter1, Nili Stein2, Ofra Barnett-Griness2, Gad Rennert3, Lea Hagoel3. 1. Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer. Electronic address: neter@ruppin.ac.il. 2. Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa. 3. Department of Community Medicine and Epidemiology, Carmel Medical Center and Faculty of Medicine, Technion, Haifa, Israel.
Abstract
BACKGROUND: Early detection of colorectal cancer (CRC) using fecal occult blood test (FOBT) reduces mortality, yet screening adherence remains low. PURPOSE:Enhancing FOBT adherence in a field experiment, using Implementation Intentions (II) technique. DESIGN: Participants were randomly assigned to a standard care group or to II experimental group. SETTING/PARTICIPANTS: A test kit was mailed to 29,833 HMO-insured members in two waves in 2011. INCLUSION CRITERIA: eligible persons aged 50-74 who underwent the test the year before. A sample of 2200 participants was interviewed over the telephone for possible cognitive and background moderators. INTERVENTION: Leaflet attached to the test kit containing an "if-then" condition and planning instructions of when, where, and how. MAIN OUTCOME MEASURE: Test performance at 2 and 6 months following mailing of the test kit, retrieved from HMO's computerized database (2011-2012). RESULTS:Adherence in the experimental group ranged 1.2%-6.6% higher than in the control group. Within 6 months of kits' mailing, test uptake for the two waves was 71.4% and 67.9% for experiment and control, respectively (χ(2)=40.58, p=0.0001). The difference remained significant after controlling for age, gender, marital status, and wave (OR=1.17, 95% CI=1.11, 1.23, p<0.0001). Test performance was related to cognitive and background variables. No interaction was found among cognitive or background variables and the intervention. CONCLUSIONS: II technique is useful in increasing adherence to CRC screening, even in a mailed form rather than a face-to-face experimental situation. Mailed II is an inexpensive and effective method, applicable for public health.
RCT Entities:
BACKGROUND: Early detection of colorectal cancer (CRC) using fecal occult blood test (FOBT) reduces mortality, yet screening adherence remains low. PURPOSE: Enhancing FOBT adherence in a field experiment, using Implementation Intentions (II) technique. DESIGN:Participants were randomly assigned to a standard care group or to II experimental group. SETTING/PARTICIPANTS: A test kit was mailed to 29,833 HMO-insured members in two waves in 2011. INCLUSION CRITERIA: eligible persons aged 50-74 who underwent the test the year before. A sample of 2200 participants was interviewed over the telephone for possible cognitive and background moderators. INTERVENTION: Leaflet attached to the test kit containing an "if-then" condition and planning instructions of when, where, and how. MAIN OUTCOME MEASURE: Test performance at 2 and 6 months following mailing of the test kit, retrieved from HMO's computerized database (2011-2012). RESULTS: Adherence in the experimental group ranged 1.2%-6.6% higher than in the control group. Within 6 months of kits' mailing, test uptake for the two waves was 71.4% and 67.9% for experiment and control, respectively (χ(2)=40.58, p=0.0001). The difference remained significant after controlling for age, gender, marital status, and wave (OR=1.17, 95% CI=1.11, 1.23, p<0.0001). Test performance was related to cognitive and background variables. No interaction was found among cognitive or background variables and the intervention. CONCLUSIONS: II technique is useful in increasing adherence to CRC screening, even in a mailed form rather than a face-to-face experimental situation. Mailed II is an inexpensive and effective method, applicable for public health.
Authors: Belinda C Goodwin; Michael J Ireland; Sonja March; Larry Myers; Fiona Crawford-Williams; Suzanne K Chambers; Joanne F Aitken; Jeff Dunn Journal: Syst Rev Date: 2019-11-04
Authors: Siu Hing Lo; Jo Waller; Charlotte Vrinten; Lindsay Kobayashi; Christian von Wagner Journal: Biomed Res Int Date: 2015-10-04 Impact factor: 3.411